Utilization Review Expert Witnesses

Utilization review expert witnesses and consultants listed here may be able to form expert opinions, draft expert witness reports, provide expert witness testimony at deposition and/or trial as or serve as consulting (non-testifying) experts on utilization review. The utilization review expert witness listings on this page are typically from fields/areas of expertise such as: HMO, Hospitalist, Internal Medicine, Long Term Care, and Medical Management.

John H Gong, MD LG Healthcare LLC

Kildeer, Illinois
Internal Medicine, Hospitalist - Outpatient Internal Medicine, Hospital Medicine, Nursing Home Medicine, Nursing Home Medical Director, Hospice Medical Director, Utilization Review, Geriatrics, Family Medicine Residency, Medical Education
I have 28 years of experience as a practicing internist and hospitalist. I have 10 years of experience in academic medicine when I was clinical faculty teaching family practice residency physicians in both outpatient internal medicine and inpatient hospital medicine. I won the Gold Apple Teaching award almost every year I was clinical faculty even though I'm an internist teaching in a family practice residency program. I'm an expert in the clinical scope of expertise of outpatient internal medicine, family medicine, and hospital medicine. I also have extensive experience in nursing home medicine and hospice care as I have been medical director for 4 skilled nursing facilities and 2 hospice agencies. I also have experience with hospital utilization review as a medical advisor for Centegra Health Systems. I left my teaching position over 10 years ago to establish a hospitalist programs in 2 different hospital settings. I am now in private practice with both an outpatient practice...

Vera Dvorak, MD TD&P Consulting Inc.

Silver Spring, Maryland
Medical Management, Long Term Care - Home Healthcare, Managed Care, Transitional Care Management, Medical Necessity Determination, Long-Term Care Planning, Evidence-Based Care Guidelines Expert, Patient-Centered Care Expert, Geriatric Services, Utilization Review, Medical Valuation, Infectious Disease
Vera Dvorak, MD, has broad and extensive experience in a continuum of care, with over 40 years working in diverse healthcare settings including home health services, palliative care, and hospice. She has also served as medical director in all of these areas. Dr. Dvorak has been a practicing physician, a managed care executive, a strategic member of corporate leadership, and vice president and medical director of hospital-based care coordination. She has been in charge of the appeals department in various managed care organizations; and is the founder of transitional care management for one of the largest healthcare systems in Northern Virginia. Dr. Dvorak’s focus has been on medical necessity determination, appropriate discharge disposition with defined short and long-term care needs. She has been a proponent of consistently applying evidence-based care guidelines to support clinical decision-making on a case-by-case basis and across the continuum of care to maximize the potenti...


Bluffton, South Carolina
HMO, Medical Management - Accountable Care, HMO & Managed Care, Appeals & Grievances, Hospital & Provider Credentialing, Utilization/Medical Necessity, Healthcare Fraud/Abuse, Utilization Review, Qui Tam, Physician Quality of Care, Physician Sanctions, Defamation, Disruptive Physicians, Population Health, Sleep Medicine
AMERICLIN® FORENSIC (AF) is a physician-led collaborative of skilled consulting clinical expert witnesses. There are currently over 50 clinicians in the AF network who seek to provide case-winning strategies for lawyers nationwide. Upon contacting us, we provide a no-charge consultation to discuss the case. Our full suite of services includes: • Free initial phone consultations with expert clinicians • Flat fee initial case reviews • Dynamic clinical case theory analysis and development Phone: (843) 949-0927 Email: [email protected] AREAS OF EXPERTISE: Accountable Care Organizations Appeals & Grievances Case Management Correctional Healthcare Disease Management Disruptive Physicians Elder Abuse Emergency Medicine Geriatrics Healthcare Fraud/Abuse HMO & Managed Care Hospital & Provider Credentialing Internal Medicine Medical Insurance Medical Necessity Patient Grievances and Appeals Patient Safety Pharmacy Pharmacology Physician Burnout Physician Credentialing Physician...